LONG COVID – LONG LASTING SYMPTOMS OF COVID-19

 

Covid-19 was a global threat since 2019 which halted our life for a couple of years. Most of us have already faced the diverse symptoms and related health issues of this pandemic. Here I wish to give much detailed information and awareness regarding Covid-19 and its long-term complications.

In medical terms, Covid-19 is caused by a virus named Sars CoV-2, which is expanded as ‘Severe Acute Respiratory Syndrome Virus-2’. It can infect many animals including humans [1]. As we already know, this disease was originated in Wuhan, China, at the end of 2019, but became a pandemic in a short span of time. The entry of Covid-19 has familiarized us with several precautionary measurements including quarantine, social distancing, facial masks, sanitizers etc. The unique characteristics of Covid-19 were the wide range of symptoms which differed from person to person. The symptoms varied from minor cases of breathlessness, cough, cold, fever, body pains, headaches, loss of smell and taste, nausea, vomiting etc to the extreme cases of tiredness, heart functioning problems, pneumonia, abnormal lag in the logical thinking, issues with mental health etc. [2, 3]. Apart from these already known facts about this disease, here I prefer to discuss a new perspective of the long-term symptoms.

In some people these symptoms disappear within a few days, but in nearly 80% people it persisted for longer i.e., several weeks to years. These variety of symptoms that reappears or persists for a long term (more than 4 weeks) are collectively termed as long Covid or post-Covid conditions [4].  In fact, the long-Covid symptoms affected vital organs including heart, lungs, brain, stomach and intestines etc. Here we discuss several health impacts of Covid-19 and their long-lasting consequences to keep the readers familiar and well-informed about this conspicuous disease.

Recent studies suggest a number of possible reasons for the long-lasting clinical conditions of long Covid as listed below.

·       Viral persistence in our healthy body organs – studies reveal that corona virus can persist in our body tissues for a long term in an inactive state (such as the lungs, ovary, uterus, penis, stomach, intestines, heart, liver, breast tissues, brain, muscles, eyes etc.) or body excretions even a year after their primary infection. Although, they exist in a dormant form, they could possibly get reactivated and retransmitted even after years, similar to Herpes and Ebola recurrence. But the scientific confirmation for the mechanism of viral persistence is yet to establish.

·   The reactivated viruses have found to destruct mitochondria, body’s energy metabolic organelles (smaller organs with energy production functions). This may lead to fatigue or tiredness. The level of tiredness is based on the level of destruction caused by viruses.

·       Exercise intolerance - It is not recommended for post-Covid patients to do physical exercise for several months at least, as the exercise intolerance is a commonly reported aftereffect in Covid patients after their recovery. The excessive physical activities may worsen the symptoms and conditions in post-Covid patients even after recovery.

·       Duration, intensity, type and location of symptoms may vary person to person (mainly based on the previous health condition of the patient).

·       Long Covid symptoms include multiple organ failure (improper functioning or dysfunction of one or more organs in our body). The below table discusses several organ failures and their corresponding clinical outcomes [4].

Organ affected by Covid-19





Diagnosis, prevention and treatment

An accurate method to diagnose long Covid is still not available. Mostly, it is being diagnosed by accounting the symptoms. The doctor decides to use currently available methods like ECG, MRI, X-ray etc to diagnose the organ specific damage and dysfunctions based on the symptoms experienced by the patient [7].

Vaccination is being recommended to prevent worsening of Covid symptoms and development of long Covid. But there is no scientific confirmation available till date regarding this matter. The effect of vaccination varies for person to person, both reduced intensity of symptoms and ineffectiveness have been reported in vaccinated population. A recent revealing of hidden side effects, including TTS (characterized by blood clot formation and a low platelet count) of Covishield vaccine is also create a panicking situation to the public [8, 9].

The treatment can be taken specifically to reduce the intensity of the symptoms, no other treatments are been invented so far.

 

References

1.     Hu B, Guo H, Zhou P et al. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol. 2021;19:141–154. https://doi.org/10.1038/s41579-020-00459-7.

2.     https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

3.     https://www.who.int/news-room/fact-sheets/detail/coronavirus-disease-(Covid-19)

4. Taribagil P, Creer D, Tahir H. ‘Long COVID’ syndrome. BMJ 2021;14(4) https://doi.org/10.1136/bcr-2020-241485.

5.  Davis HE, McCorkell L, Vogel, JM et al. Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol 2023;21:133–146. https://doi.org/10.1038/s41579-022-00846-2.

6.     https://www.agappe.com/in/blog-details/impact-of-post-Covid-conditions-on-public-health.html

7.   Srikanth S, Boulos JR, Dover T, Boccuto L, Dean D. Identification and diagnosis of long COVID-19: A scoping review. Prog Biophys Mol Biol. 2023;182:1-7. doi: 10.1016/j.pbiomolbio.2023.04.008

8.     https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/astrazeneca-admits-its-Covid-vaccine-can-cause-rare-side-effect/articleshow/109710995.cms

9.     https://www.healthdirect.gov.au/thrombosis-with-thrombocytopenia-syndrome-tts


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